Military Families

U/s

Found out today that the gender ultrasound is not covered by tricare prime but we really want to find out who we're having when the time comes. We don't have any other insurance and not sure what to do in this situation. Any one else that was stuck in this situation find a way to find out before the baby was born? 
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Re: U/s

  • TRICARE will cover all ultrasounds that are coded as medically necessary.  Your OB will most like schedule for an anatomy scan at about 20 weeks to ensure that your baby is on track.  A perk to the anatomy scan is that parents-to-be typically learn what sex their baby is.  But, if the baby does not cooperate, you will be out of luck.  You could opt to go to one of u/s businesses that do gender checks and pay out of pocket 
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  • That's correct, tricare will not cover an ultrasound solely to determine the sex of the baby. However, tricare does cover all medically necessary ultrasounds, including the 20-week anatomy scan. This is when most parents find out the sex of their babies if the tech is able to see it. If you ask for a "gender" ultrasound, it won't be covered because it isn't necessary for you to know what the baby is.

    At the top of this board is a FAQ clicky. There is a lot of info in it about being pregnant on tricare. 

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  • No insurance covers an ultrasound for the sole purpose to determine gender. Tricare will cover the anatomy scan and any other scan coded for medical purposes.
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  • image Lissa832:
    No insurance covers an ultrasound for the sole purpose to determine gender. Tricare will cover the anatomy scan and any other scan coded for medical purposes.

    Ditto everyone, especially the bolded line.  There is SO much more to the anatomy scan than just finding out the sex of your baby, and that is why it's considered a medically necessary u/s.  Having an u/s just to determine the sex is not medically necessary, and most doctors won't even do them.  Some people choose to pay out of pocket to go to a strip mall place that does them to find out earlier than their Dr, since the a/s is usually done between 18-20 weeks. 

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  • I recommend you have your OB or family practitioner write you a referral for the ultrasound. I do this for all of mine and I have not had any issues. In the letter the doctor needs to say it is necessary to check proper growth. I'm also high risk so they put that on the referral. :) Good luck!
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  • If your LO refuses to cooperate at the A/S at 20ish weeks, there are imaging centers (at least in large towns usually) that will offer this service for about $75-$100. If you are desperate to find out, when the time comes, you can schedule this.
  • image mv9310:
    I recommend you have your OB or family practitioner write you a referral for the ultrasound. I do this for all of mine and I have not had any issues. In the letter the doctor needs to say it is necessary to check proper growth. I'm also high risk so they put that on the referral. :) Good luck!

    There is no need for a referral, the anatomy scan is routinely scheduled.  All the doctor has to do is put in the order for an anatomy scan, and then you call and make the appointment (when they want you to come in depends on your hospital, but it's usually between 18 and 22 weeks for military hospitals).   

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  • If I remember correctly, you are at Offutt.  That's where we are.  The U/S tech here is really nice and as soon as you walk in for your 20 week U/S he asks you if you want to know.  Also, Offutt's radiology department is brand new.  They just moved it down the hall from it's previous location and have brand new machines.  Also, if you want to get 3D U/S photos, DON'T get a referral to go off base.  They do them for free at Radiology at Offutt's clinic and they will give you print outs and a CD of the images.  They did this for us last year for daughter and also when we went in today for Baby #2.  I have friends here who went off base for their U/S and wound up having to pay mega bucks for the 3D images when they could have gotten them for free by staying on base.
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  • image TomHope2011:
    If I remember correctly, you are at Offutt.  That's where we are.  The U/S tech here is really nice and as soon as you walk in for your 20 week U/S he asks you if you want to know.  Also, Offutt's radiology department is brand new.  They just moved it down the hall from it's previous location and have brand new machines.  Also, if you want to get 3D U/S photos, DON'T get a referral to go off base.  They do them for free at Radiology at Offutt's clinic and they will give you print outs and a CD of the images.  They did this for us last year for daughter and also when we went in today for Baby #2.  I have friends here who went off base for their U/S and wound up having to pay mega bucks for the 3D images when they could have gotten them for free by staying on base.
    yes we're at offutt. Thanks for calming me down. the tricare lady who came in to do her presentation about what's covered during our ob orientation stirred us all up a bit. About the 3D images, do you have to make a separate appt or can you just ask while you're getting an ultrasound? 
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  • image og0611:
    image TomHope2011:
    If I remember correctly, you are at Offutt.  That's where we are.  The U/S tech here is really nice and as soon as you walk in for your 20 week U/S he asks you if you want to know.  Also, Offutt's radiology department is brand new.  They just moved it down the hall from it's previous location and have brand new machines.  Also, if you want to get 3D U/S photos, DON'T get a referral to go off base.  They do them for free at Radiology at Offutt's clinic and they will give you print outs and a CD of the images.  They did this for us last year for daughter and also when we went in today for Baby #2.  I have friends here who went off base for their U/S and wound up having to pay mega bucks for the 3D images when they could have gotten them for free by staying on base.
    yes we're at offutt. Thanks for calming me down. the tricare lady who came in to do her presentation about what's covered during our ob orientation stirred us all up a bit. About the 3D images, do you have to make a separate appt or can you just ask while you're getting an ultrasound? 

     You can ask them to do 3D images when you're having an ultrasound in radiology (I don't think the ultrasound machines they have in the OB clinic can do that, but I could be wrong).  Not every tech will do it, but the nice ones will try to get some 3D pictures after they're done getting all the regular pictures for the anatomy scan. 

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  • He does the 3D images at the end of the appointment once he gets all of the required regular U/S images done of the baby.
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  • image ArmyWife114:

    image mv9310:
    I recommend you have your OB or family practitioner write you a referral for the ultrasound. I do this for all of mine and I have not had any issues. In the letter the doctor needs to say it is necessary to check proper growth. I'm also high risk so they put that on the referral. :) Good luck!

    There is no need for a referral, the anatomy scan is routinely scheduled.  All the doctor has to do is put in the order for an anatomy scan, and then you call and make the appointment (when they want you to come in depends on your hospital, but it's usually between 18 and 22 weeks for military hospitals).   

     I think it is different for you then because I am required to do a referral for anything that isn't medically necessary. Tricare does not cover any of the ultrasounds during pregnancy where I am at.  

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  • Mv Tricare is the same coverage regardless of where your stationed. If your needing a referral for each ultrasound your doctor is unclear on how to deal with Tricare and is not coding them correctly. I have had at least 6 ultrasounds with no problems and no extra referrals
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